Category Archives: General Safety

NTSB Video Series Highlights Safety Benefits of Connected-Vehicle Technology, Raises Concern about Future of V2X

By Member Michael Graham

Today, the NTSB released a four-part video series: “V2X: Preserving the Future of Connected-Vehicle Technology.” Vehicle-to-everything (V2X) is one of the most promising life-saving technologies available today. While radars and sensors are limited to line-of-sight and are often impeded by inclement weather, V2X technology uses direct communication between vehicles and with infrastructure. Additionally, V2X technology increases the safety and visibility of vulnerable road users by alerting drivers to the presence of pedestrians, bicyclists, and motorcyclists that may be outside a driver’s or vehicle‑based sensor’s field of observation.

Despite the immense safety potential of V2X, the Federal Communications Commission’s (FCC’s) recent actions threaten its basic viability. In May 2021, the FCC finalized the rulemaking to substantially reduce the available spectrum for V2X applications by 60 percent. This ruling retained only 30 MHz for transportation safety applications and invited interference from the surrounding bands from unlicensed Wi-Fi devices. Research by the US Department of Transportation (DOT) demonstrated that expected interference into the spectrum would further compromise the integrity of safety applications—rendering V2X untenable.

In this video series, I had the privilege of interviewing eight experts from government, industry, academia, and associations about the safety benefits and the maturity level of V2X technology, the reasons for its scarce deployment, and the impact of the FCC’s recent actions to limit the spectrum available for transportation safety.

I talked with some of the leading voices in the V2X space, including:

  • Debby Bezzina, Center for Connected and Automated Transportation, University of Michigan Transportation Research Institute
  • Bob Kreeb, National Highway Traffic Safety Administration
  • Ken Leonard, US Department of Transportation’s Intelligent Transportation Systems (ITS) Joint Program Office
  • Laura Chace, ITS America
  • Scott Marler, American Association of State Highway and Transportation Officials
  • John Hibbard, Georgia Department of Transportation
  • John Capp, General Motors
  • John Kenney, Toyota

The NTSB first issued a safety recommendation to the FCC to allocate spectrum for V2X technology in 1995, and we continue to fervently believe in the promise of V2X technology to save lives.

This series was developed as part of the NTSB’s Most Wanted List safety topic, Require Collision-Avoidance and Connected-Vehicle Technologies on all Vehicles. I sincerely appreciate each of the eight guests who graciously agreed to participate in the series.

I encourage you to watch all four episodes of this series on the NTSB YouTube channel. You can learn more about the video series, including our featured guests and supporting research, on the NTSB’s V2X web page.

A New Year’s Resolution We All Can Make: Prioritize Safety

By Nicholas Worrell, Chief, NTSB Safety Advocacy Division

As 2021 ends, it’s time to reflect on the past 12 months and begin to set goals for the year ahead. After all, as Zig Ziglar once said, “if you aim at nothing, you will hit it every time.” So, let us all aim to improve the safety of our transportation system in 2022.

The NTSB recognizes the need for improvements in all modes of transportation–on the roads, rails, waterways, pipelines, and in the sky. Our 2021–2022 NTSB Most Wanted List of Transportation Safety Improvements (MWL), released in April this year, highlights the transportation safety improvements we believe are needed now to prevent accidents and crashes, reduce injuries, and save lives. We use the list to focus our advocacy efforts and to serve as an important call to action. We ask lawmakers, industry, advocacy, community organizations, and the traveling public to act and champion safety.

As a fellow safety advocate, I ask you to join me in a New Year’s resolution: I pledge to do my part to make transportation safer for all.

To help you take steps to accomplish this resolution, our MWL outlines actions you can take to make transportation safer:

  1. Require and Verify the Effectiveness of Safety Management Systems in all Revenue Passenger-Carrying Aviation Operations
  1. Install Crash-Resistant Recorders and Establish Flight Data Monitoring Programs
  1. Implement a Comprehensive Strategy to Eliminate Speeding-Related Crashes
  1. Protect Vulnerable Road Users through a Safe System Approach 
  1. Prevent Alcohol- and Other Drug-Impaired Driving
  1. Require Collision-Avoidance and Connected-Vehicle Technologies on all Vehicles
  1. Eliminate Distracted Driving
  1. Improve Passenger and Fishing Vessel Safety
  1. Improve Pipeline Leak Detection and Mitigation
  1. Improve Rail Worker Safety

Achieving these improvements is possible; otherwise, they wouldn’t be on our list. The NTSB MWL includes tangible changes and solutions that will, undoubtedly, save lives. But it’s only words on a list if no action is taken. Unlike Times Square on New Year’s Eve, we cannot drop the ball on improvements to transportation safety. The clock is ticking, and the countdown has begun—we can’t afford to waste any more time. Make the resolution to do your part to make transportation safer for all!

In closing, I’d like to thank the transportation safety stakeholders, industry, lawmakers, and advocates we have worked with in 2021 and we look forward to working together in 2022 and beyond.

Drive Sober and Save Lives the Holiday Season

By Member Tom Chapman

Unlike last year when many holiday gatherings were cancelled due to the pandemic, many of us will return to visiting family and attending holiday parties this year. Some may see this as an opportunity for a 2020 do-over and may overindulge on merriment.

The holiday season is a time of increased impaired-driving crashes due to these celebrations and gatherings. The President has designated December as National Impaired Driving Prevention Month, and it serves as a reminder that traffic fatalities and injuries attributed to impaired driving are 100 percent preventable.

In 2019, according to the National Highway Traffic Safety Administration (NHTSA), 10,142 people were killed in traffic crashes in which at least one driver had a blood alcohol concentration (BAC) level of 0.08 g/dL or higher. That number comprises 28 percent of the 36,096 traffic fatalities that year.  Also of concern, NHTSA estimated a 9 percent increase in police-reported alcohol involved crashes between 2019 and 2020.  These deaths are not abstract statistics. These were mothers and fathers, husbands and wives, children, friends, and other loved ones. They are people who will be deeply missed at this year’s holiday gatherings.

In addition to alcohol, there are other impairing substances, such as marijuana, other illegal drugs, and prescribed and over-the-counter medications. These can all be as dangerous as alcohol for a driver. As we continue to understand more about the extent to which drugged driving contributes to fatalities and injuries, we are certain that the prevalence of this, as well as multiple or “poly-drug” use while driving, is on the rise.

In June, NHTSA published an update on research looking at drug and alcohol prevalence in seriously and fatally injured road users before and during the COVID-19 public health emergency. The overall picture is very troubling. In general, drug and alcohol prevalence among drivers seriously injured or killed in crashes increased during the pandemic. Significant increases were reported for drivers testing positive for cannabinoids and multiple substances. These are not the trends that we want to see.

The NTSB has issued specific recommendations that, if implemented, would help prevent these deaths and injuries. They include required all-offender ignition interlocks, .05 (or lower) BAC limits, and a national drug testing standard. Our 2021-2022 Most Wanted List of Transportation Safety Improvements includes the safety item “Prevent Alcohol- and other Drug-impaired Driving,” with these and several additional safety recommendations remaining open.

Congress recently passed the Infrastructure Investment and Jobs Act, which advances some of NTSB’s most important safety recommendations. For example, the new law requires the Secretary of Transportation to issue a final rule requiring all new passenger motor vehicles to be equipped with advanced drunk driving prevention technology within three years. I am encouraged and hopeful we’ll see this technology incorporated soon, as it could be a game-changer for alcohol-impaired driving.

By exercising personal responsibility, you can do your part to prevent impaired driving crashes during the holiday season. It’s simple. Choose drinking or driving, but not both. Have a designated driver. Call a taxi or ride-share service. These basic steps will save lives. Let’s ensure there will be many more enjoyable holiday seasons to come.

Paying Passengers Deserve Safety on All Flights

By Member Michael Graham

In 2015, the Federal Aviation Administration (FAA) required commercial airlines to develop a comprehensive safety management system (SMS) to improve safety for the flying public. An SMS is an organization-wide system that ensures operators are properly identifying, assessing, and mitigating the conditions that exist for an accident to occur.

The FAA, however, has not required the same for revenue passenger-carrying operations under Title 14 Code of Federal Regulations Parts 91 and 135, leaving passengers on these flights at unnecessary risk. Similar to passengers of commercial airlines, those passengers who pay for a charter flight, skydiving experience, or hot air balloon ride exercise no control and bear no responsibility over the airworthiness or operation of which they are being flown. Therefore, paying passengers of Part 91 and Part 135 flights deserve a similar level of safety as those who fly on a commercial airline. That is why Require and Verify the Effectiveness of Safety Management Systems in all Revenue Passenger-Carrying Aviation Operations is on the NTSB’s 2021–2022 Most Wanted List of Transportation Safety Improvements.

The Problem

Togiak, AK – Separated section of empennage with vertical and horizontal stabilizers and rudder attached.

Since the airlines were required to develop an SMS in 2015, the NTSB continues to investigate Part 91 and Part 135 accidents that could have been prevented by an effective SMS—all involving paying passengers—including the following:

  • On October 2, 2016, Ravn Connect flight 3153, a turbine-powered Cessna 208B Grand Caravan airplane operated under Part 135, collided with steep, mountainous terrain northwest of Togiak Airport in Alaska, killing both commercial pilots and their passenger. The operator did not have an SMS, and we found that after experiencing two previous controlled flight into terrain (CFIT) accidents in the preceding three years the company had missed opportunities to adequately assess this CFIT-related risks and implement more effective strategies for preventing such accidents.
  • On May 15, 2017, a Learjet 35A departed controlled flight while on a circling approach to runway 1 at Teterboro Airport in New Jersey, and impacted a commercial building and parking lot. The pilot-in-command (PIC) and the second-in-command (SIC) died. The operator lacked both an SMS and a flight data monitoring program, and the company did not identify or mitigate hazards that contributed to this accident, including the pairing of pilots who had exhibited difficulties in training, the informal practice of some captains who allowed unapproved copilots to serve as pilot flying, and other patterns of flight crew procedural noncompliance.
  • On March 11, 2018, an Airbus Helicopters AS350 B2 lost engine power during an aerial photography flight and ditched on the East River in New York City. The pilot sustained minor injuries and his five passengers drowned. Again, the operator lacked an SMS and, although the operator’s employees were aware of the potential hazards that led to the accident, the operator did not have a robust safety program that could adequately prioritize and address hazards that played a role in this accident, including the potential for entanglement of a passenger harness/tether system with floor-mounted engine controls, the inability of passengers to evacuate without assistance, and the possibility the emergency flotation system might only partially inflate due to difficulties with the float activation mechanism.
  • On June 21, 2019, a Beech King Air 65-A90 airplane, N256TA, impacted terrain after takeoff from Dillingham Airfield, Mokuleia, Hawaii. The pilot and 10 passengers were fatally injured, and the airplane was destroyed by impact forces and a postcrash fire. In this accident, the operator failed to address numerous safety issues that a formal SMS would likely have identified as significant risks and prevented the accident. These included allowing passengers to be transported in a poorly maintained airplane, not implementing any standard operating procedures (SOPs) or written guidance for the company’s parachute operations, providing no structured initial or recurrent training for company pilots, using flawed methods in calculating the weight and balance of its flights, and allowing its pilot to routinely violate numerous Federal Aviation Regulations. In April 2021, the NTSB issued Safety Recommendation A-21-13, which asked the FAA to require SMS for the revenue passenger-carrying operations discussed in the Part 91 aviation investigation report; these operations included parachute jump flights.

These accidents seemingly had little in common, yet, in each case, an effective SMS might have helped the operator identify hazards or better mitigate those that were already known.

An Effective SMS

Any operator can print out the four pillars of an SMS, put up a poster, and add an anonymous comment box to the breakroom. However, implementing an effective SMS that changes safety behavior in an organization is not a box-checking exercise. An effective SMS is a management system that brings safety conscious behaviors to the forefront of an organization, which aids in identifying and mitigating risks inherent in flight operations and other activities. Every day, every task.

An effective SMS must fully address the following four pillars:

  • Safety policy
    • Sets objectives, assigns responsibilities, and develops standards
    • Clearly defines roles and responsibilities
    • Engages accountable executive
  • Safety risk management
    • Systematic processes for identifying hazards and mitigating risks
  • Safety assurance
    • Monitors, measures, audits, and assesses the performance of SMS
  • Safety promotion
    • Ensures a positive and just safety culture
    • Circulates and incorporates safety lessons
    • Advocates, communicates, and trains the principles of SMS

By establishing an effective SMS and creating a safety culture that fosters the free flow of safety-related information and organizational learning about the nature of operational risks, operators will reduce the likelihood of an accident and improve the safety of their flight operations.

What Can Be Done

Oversight is necessary to ensure operators adhere to the principles and processes of an effective SMS to provide sufficient safety to paying passengers. The NTSB has investigated numerous accidents involving operators whose deficient SMS failed to identify and mitigate the conditions that contributed to the accident. Therefore, the NTSB calls on the FAA to require SMS for all revenue passenger-carrying Part 91 and Part 135 operations and provide ongoing oversight.

To operators, the NTSB’s investigations repeatedly demonstrate that an effective SMS could have identified the hazards and mitigated the risks that led to the accidents. Do not wait for an accident to occur or a FAA mandate to invest in the safety of your passengers, pilots, and other personnel, voluntarily implement an effective SMS today.

World Day of Remembrance for Road Traffic Victims

By Chair Jennifer Homendy

November 21 is the World Day of Remembrance for Road Traffic Victims. It is a day to honor the 1.3 million lives lost each year around the world in motor vehicle crashes.

Today, I urge everyone to take a moment to remember all those who have lost loved ones in crashes, as millions have done around the world since 1995. Here in the United States, traffic deaths are up 18 percent over the first half of 2020. We are on pace to lose 40,000 Americans this year alone.

My thoughts are with all who have lost loved ones, but especially those I’ve met who lost loved ones in crashes that the NTSB has investigated, and the survivor advocates I’ve gotten to know over the years.

We need to remember these numbers are people from our communities. They are lives lost: mothers, fathers, or children suddenly, permanently gone; brothers and sisters absent from holiday gatherings; friends missing from a baby shower. We record our losses in data tables, but we feel them at the dinner table, and in the graduations, weddings, and birthdays never celebrated.

At a November 10 virtual roundtable on the need for our nation to transition to a Safe System approach, I called for a moment of silence in advance of the World Day of Remembrance. I said then that, for the NTSB, the toughest part of our job is facing family members after a tragedy, explaining that their loved one’s death was 100 percent preventable and that we’ve issued recommendations which, if acted upon, would have prevented the crash and the loss of their loved one.

Then I said that we need a paradigm shift in how we address this ever-growing public health crisis.

For 26 years now, the world has memorialized the victims of motor vehicle crashes, and we have been right to remember them. No loss should be forgotten. But these are unnecessary losses. They must not be remembered only in words.

They deserve and demand action now.

They demand to be remembered with road treatments, traffic calming measures, engineering speed assessments, road safety laws, and other investments that will result in safe roads and safe speeds on those roads.

They demand to be remembered with the manufacture of safe vehicles that should come standard with better technology for avoiding collisions, including collisions with pedestrians, bicyclists, and motorcyclists.

They must be remembered with vehicle sizes and shapes that are less likely to result in the pedestrian and bicyclist deaths that we have seen so often.

They demand to be remembered with ignition interlocks for all impaired drivers, in the development of in-vehicle alcohol detection technology, and in fair and just traffic law enforcement.

They demand to be memorialized with increased investments in alternative modes of transportation, like public transit, which will reduce crashes on our roads, in newly changed laws to improve road safety, and in the enforcement of existing laws.

But most of all, these victims should be remembered as what they were: flesh and blood. Human. Vulnerable.

Put that image at the center of all the other aspects of our roads, and you’ll see the road as we must in order to finally make it safe. Don’t think of numbers, think of people. Put them at the center of every decision about our road system. That’s the paradigm shift that we need—to make our many layers of traffic hazards into layers of traffic protection, so that when crashes happen, nobody pays for it with their life.

This Day of Remembrance, let’s remember that the candle we light to remember victims is more than just a memorial; it’s a light showing the way to a safer tomorrow.